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Pediatric Cardiology - Tetralogy of Fallot

​​​​​​​​​​​​​​​Tetralogy of Fallot (TOF) is a congenital heart defect (a child is born with it) and is a combination of several things:

  • Pulmonary stenosis - a narrowing of the pulmonary valve or area below the valve causing a blockage of bloodflow from the heart to the lungs.
  • Ventricular Septal Defect (VSD) - a hole in the dividing wall between the lower chambers of the heart (ventricles).
  • A thickened right ventricle.
  • An aorta that is shifted toward the right side of the heart causing it to sit over or "override" the ventricles above the ventricular septum.

Blood that should go to the lungs, goes instead through the hole in the heart wall and goes to the body without getting its supply of oxygen from the lungs. 

Tetralogy of Fallot may cause spells of blueness, labored breathing, and fainting and the child may tire and turn blue with exercise.

Marshfield Clinic has three full time pediatric cardiologists who are able to diagnose and treat any child with a congenital heart defect.


A child with TOF requires heart surgery to correct the heart defects. Surgery is generally done in the first year of life.

Cardiac Catheterization
In rare cases, a temporary procedure may be needed to increase blood flow to the lungs until a complete surgical repair can be done. 

A catheter is inserted into a blood vessel in the groin. With the help of live x-rays, the catheter is advanced up through the blood vessel until it reaches the heart. 

A tiny balloon at the end of the catheter is then inflated one or more times in the pulmonary valve, which opens the valve leaflets. Then the catheter and balloon are removed.

Through open heart surgery, the ventricular septal defect is repaired with stiches and a patch and the tissue causing obstruction at or below the pulmonary valve is removed as needed. In addition, the pulmonary artery may be enlarged.​​

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